JP2015069498A - Clinical path management device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a clinical path management device which effectively utilizes a clinical path to allow smooth treatment.SOLUTION: A clinical path approval unit 58 refers to authority information of clinical paths stored in a clinical path DB 18 to extract clinical paths which a user has authority to approve, and makes the user select a clinical path to be approved, from the extracted clinical paths. When a clinical path to be approved is selected, information (electronic signature) showing that the clinical path is approved and a certificate certifying that the approval has been performed by a terminal of the user having the approval authority are generated. The electronic signature and the certificate are stored in association with the approved clinical path to update the clinical path DB 18.

Description

  The present invention relates to a clinical path management apparatus that manages clinical paths.

  In recent years, clinical institutions have been introducing clinical paths. The clinical path shows a step-by-step treatment (treatment or examination) plan until reaching the target state, and the treatment contents are standardized by performing the treatment according to the clinical path, and the understanding level of medical staff and patients. Can be increased. Thereby, in a medical institution, a stable and high-quality treatment is possible. In addition, patients can be treated with peace of mind after being convinced.

  Generally, the clinical path is managed in the form of printed paper. However, as described in Patent Document 1 below, the clinical path is managed in the form of electronic data. In Patent Document 1, the clinical path can be browsed by accessing a database storing clinical paths from various terminals such as a medical staff terminal and a patient terminal. Further, in Patent Document 1 below, a viewing authority and an editing authority for a clinical path are set, and only a user having the viewing authority and the editing authority is allowed to view and edit the clinical path.

International Publication No. 2005/122033

  The above Patent Document 1 is convenient in that the clinical path can be viewed from various terminals such as a medical staff terminal and a patient terminal, but there are many inconveniences when actually proceeding with the treatment based on the clinical path, There was also a problem that smooth treatment was hindered.

  That is, when actually performing treatment, patient approval is required, and the medical institution explains the content of treatment to the patient and performs treatment after receiving patient approval. The patient approves the treatment by submitting a consent form to the medical institution.

  However, in the above-mentioned patent document 1, such patient approval is not considered, and it is inconvenient because it is necessary to manage the consent form used for the approval separately from the clinical path. Moreover, there is a possibility that the correspondence relationship between the consent form and the clinical path may be lost due to a mistake. Furthermore, there is also a problem that it is not possible to start treatment because it is not possible to know whether or not the patient's approval has been obtained only by browsing the clinical path.

  Also, there are cases where the patient cannot be approved by himself / herself, such as when the patient is unconscious or has dementia. However, in the said patent document 1 which is not considered with respect to approval, of course, it is not considered also about the point of receiving approval when a patient himself cannot approve.

  The present invention has been made in view of the above-described background, and an object of the present invention is to provide a clinical path management apparatus that can effectively use a clinical path and can perform a smooth treatment.

  In order to achieve the above object, the clinical path management apparatus of the present invention stores a clinical path database in which a clinical path indicating a stepwise treatment plan until reaching a target state is stored, and user information relating to a user. The action plan is approved when an instruction to approve the treatment plan is input from the user information database, the user authentication unit that authenticates the user based on the user information, and a user who has approval authority to approve the action plan. And a clinical path approval unit for storing information indicating that the information is associated with the clinical path.

  Approval authority to accept and delete approval authority when an instruction to grant and delete approval authority is input from a user who has authority to change approval range that can grant and delete approval authority You may provide the change part.

  When an instruction to browse the clinical path is input from a user who has browsing authority to view the clinical path, a clinical path distribution unit that receives the input instruction and distributes the clinical path may be provided.

  When an instruction to create a clinical path is input from a user who has a creation authority capable of creating a clinical path, a clinical path creation unit that receives the input instruction and creates a clinical path may be provided.

  The authority possessed by the user may be stored in association with the clinical path.

  A preset authority may be given to a preset user when creating a clinical path.

  At the time of creating a clinical path, an approval authority may be given to a patient who is a treatment target in the clinical path, and an approval range change authority may be given to a patient and a doctor in charge of the patient.

  The authorization range change authority granted to the attending physician may be an authority that can grant the authorization authority up to the patient's relatives.

  When creating a clinical path, a viewing authority may be given to a patient who is a treatment target in the clinical path and a doctor in charge of the patient.

  The viewing authority given to the doctor in charge is the authority to view all the information constituting the clinical path, and the viewing authority given to the patient is the authority to view only a part of the information constituting the clinical path. There may be.

  The present invention stores a clinical path in a database, and stores an instruction to approve a clinical path in association with a clinical path when an instruction to approve the clinical path is input from a user having the authority to approve the clinical path. Since the path and information regarding approval / disapproval are centrally managed, the clinical path can be used more effectively than when managing documents with approval / disapproval separately from the clinical path. It is possible to grasp the presence or absence), and smooth treatment is possible.

It is the schematic which shows the structure of a medical assistance system. It is explanatory drawing which shows the data system of a clinical path. It is explanatory drawing which shows the state by which the clinical path | pass was displayed. It is explanatory drawing which shows user information. It is a block diagram which shows the structure of an application server. It is a functional block diagram of an application server. It is explanatory drawing which shows the function of a clinical path creation / change part. It is explanatory drawing which shows the function of a clinical path delivery part. It is explanatory drawing which shows the function of a clinical path approval part. It is explanatory drawing which shows the function of an authority change part. It is explanatory drawing which shows an authority change screen.

  In FIG. 1, the medical support system 10 supports medical care using a clinical path 26 (see FIGS. 2 and 3), and manages the clinical path 26 (creation, editing, storage, distribution, etc.). A path management device 12 is provided. Terminals 16 a to 16 i of users of the medical support system 10 are connected to the clinical path management device 12 via a network 14 such as the Internet. The clinical path management apparatus 12 distributes an operation screen such as a GUI (Graphical User Interface) to the terminals 16a to 16i via the network 14, and the clinical path 26 according to an operation instruction input from the terminals 16a to 16i through the operation screen. Manage.

  Each of the terminals 16a to 16i is a desktop type equipped with a connection function to the network 14, an input means such as a keyboard and a mouse, and a display means such as a liquid crystal display (or a touch panel display that serves as both the input means and the display means). Well-known electronic devices such as personal computers, notebook computers, tablet terminals, mobile phones and smartphones. These terminals 16a to 16i are used by the user of the medical support system 10. The users of the medical support system 10 include users on the patient side such as patients, their relatives, and friends, and users on the medical institution such as medical doctors in charge of treating patients and medical staff assisting the medical doctors in charge.

  The clinical path management device 12 is installed in, for example, an operating company that operates the medical support system 10. The clinical path management apparatus 12 includes an application server 17 that executes various functions such as distribution of operation screens and management of the clinical path 26 according to an application program (AP) 30 (see FIG. 5) described later, and a clinical path database (DB) 18. And a user information DB (DB) 20, which are connected via a network 22 such as a LAN.

  As shown in FIGS. 2 and 3, the clinical path DB 18 stores a template 24 that is a base for creating a new clinical path 26, and a created clinical path 26 created based on the template 24. The 2 shows a system of data constituting the clinical path 26, and FIG. 3 shows a state displayed on the display in order to view the clinical path 26.

  The clinical path 26 shows a step-by-step treatment plan until reaching a target state, and identification information (user ID or the like) for identifying a patient to be treated, or treatment of the clinical path 26 as a whole. Various information such as the content (title) and the content of the treatment (event) at each stage of the clinical path 26 (schedule, time, place, person in charge, target) are associated with each other.

  Further, authority information is associated with the clinical path 26. The authority information can be edited (can add or delete events, change the schedule, time, place, person in charge, etc.), the viewing authority that can view the clinical path 26, and can be granted or deleted. Such as an authorized viewing range change authority, an authorization authority that can approve the clinical path 26, an authorization area change authority that can grant or delete the authorization authority, and identification information for identifying a user having each authority (such as a user ID) ) Are associated with each other.

  In addition, when the clinical path 26 is generated, the initial state authority given to each user is set in advance, and when the clinical path 26 is generated, a predetermined authority is automatically set for a predetermined user. To be granted. Specifically, the editing authority is granted to the attending physician, the viewing authority is granted to the patient, the attending physician, and the medical staff involved in the event, the viewing range change authority is granted to the patient and the attending physician, and the approval authority is granted. Granted to the patient, the authorization range change authority is granted to the patient and the attending physician respectively. The authority in the initial state given to each user is not limited to the above-described example, and can be changed as appropriate.

  Further, the clinical path 26 is also associated with approval information (such as an electronic signature and a certificate thereof) indicating whether or not approval is obtained from a person having approval authority for the treatment plan indicated by the clinical path 26. ing.

  As shown in FIG. 4, the user information DB 20 stores user information 28 related to the user. The user information 28 includes identification information for identifying a user such as a user name and a user ID, a terminal ID for identifying a terminal owned by the user, user status information (a user's position (a user is a patient or a relative, The patient's position, such as a friend), the relationship with other users when the user is in the patient's position (information indicating who the user's relatives and friends are), and the user's position at the medical institution Are associated with each other).

  The user information 28 is distinguished for each user, and the user information for one person is generated, for example, in a user registration process performed at the first use of the medical support system 10 and stored (newly registered) in the user information DB 20. In the user registration process, the user is requested to input the user name and status information. When the user inputs the user name and status information from his / her terminal, a user ID is assigned and the terminal of the terminal from which information is input The user information is generated by acquiring the ID and associating it with the user ID together with the user name and status information.

  The user registration is not limited to an example in which the user inputs his / her user information and registers the user himself / herself, and can be performed by an appropriate method. For example, the user (patient) may register his / her relative or friend as a user. In this case, it is only necessary to input user information such as the name of the relative and the terminal ID registered by the patient from his / her terminal. Of course, the patient's doctor may register the relative of the patient in charge by inputting user information such as the name of the patient's relative and the terminal ID from his / her terminal.

  As shown in FIG. 5, the application server 17 is configured by installing a control program such as an operating system and an AP 30 for causing the computer to function as the application server 17 based on a computer such as a personal computer or a workstation.

  The application server 17 includes a storage device 32, a memory 34, a CPU 36, and a communication I / F 38, which are connected via a data bus 40. The storage device 32 is, for example, a hard disk drive, and is an internal storage built in the main body of the application server 17. The storage device 32 stores a control program, AP 30 such as application server software, images and messages displayed when the AP 30 is executed, display data 42 for displaying various operation screens, and the like. .

  The memory 34 is a work memory for the CPU 36 to execute processing. The CPU 36 centrally controls each part of the computer by loading a control program stored in the storage device 32 into the memory 34 and executing processing according to the program. The communication I / F 38 includes an interface for communicating with the networks 14 and 22, and the application server 17 passes through the communication I / F 38 and the networks 14 and 22, the clinical path DB 18, the user information DB 20, and It communicates with the terminals 16a to 16i.

  The AP 30 is a program for causing a computer to execute various functions. The CPU 36 centrally controls each unit of the computer by loading the AP 30 stored in the storage device 32 into the memory 34 and executing processing according to the program.

  As illustrated in FIG. 6, when the AP 30 is activated, the CPU 36 cooperates with the memory 34 to perform a user authentication unit 50, a process selection unit 52, a clinical path creation / editing unit 54, a clinical path distribution unit 56, and a clinical path approval. Functions as the unit 58 and the authority changing unit 60.

  The user authentication unit 50 receives an access request to the medical support system 10 input from the terminals 16a to 16i and performs user authentication. The access request is transmitted to the user authentication unit 50 by, for example, inputting a user ID on a website opened on the network 14 by the operating company of the medical support system 10. Upon receiving the access request, the user authentication unit 50 authenticates the user by checking the user ID input together with the access request with the user information 28. When the user is authenticated, not only can the user be identified, but the relative of the user and the friend stored in the status of the user information 28 can be identified as to who the user's relative and friend are. When performing user authentication, not only the user ID but also a password may be input, and the user authentication may be performed using the user ID and the password.

  When the user authentication is completed, the process selection unit 52 operates. The processing selection unit 52 is provided to select the processing contents to be executed by the AP 30 and includes “clinical path creation / editing”, “clinical path browsing”, “clinical path approval”, and “authority change” that can be executed by the AP 30. The processing contents to be executed by the AP 30 are selected from the four processes.

  Specifically, the process selection unit 52 distributes a process selection screen, which is an operation screen for selecting one of the four processes described above, to the authenticated user's terminal in accordance with the operation. For example, four tags corresponding to the four processes described above are provided on the process selection screen, and the user operates his / her terminal according to the process selection screen and clicks one of the four tags. One of the two processes can be selected. When the process is selected, an operation signal indicating the selection content is input from the user terminal to the process selection unit 52. The process selection unit 52 activates any of the clinical path creation / editing unit 54, the clinical path distribution unit 56, the clinical path approval unit 58, and the authority change unit 60 based on the input operation signal.

"Clinical path creation / editing"
In FIG. 6, when “clinical path creation / editing” is selected from the four processes, the process selection unit 52 activates the clinical path creation / editing unit 54. As shown in FIG. 7, the clinical path creation / editing unit 54 displays a clinical path creation / editing screen, which is an operation screen for creating and editing the clinical path 26 in accordance with the operation, on the terminal of the authenticated user. Deliver to Then, an operation signal corresponding to the input operation performed by the user through the clinical path creation / editing screen is input from the user terminal to the clinical path creation / editing unit 54. The clinical path creation / editing unit 54 creates and edits the clinical path 26 based on the input operation signal.

  In newly creating the clinical path 26, the clinical path creation / editing unit 54 allows the user to select one of the templates 24 of the clinical path 26 stored in the clinical path DB 18, and the date, person in charge, patient name, etc. To input. In the editing of the clinical path 26, the clinical path creation / editing unit 54 refers to the authority information of the created clinical path 26 stored in the clinical path DB 18, and extracts the clinical path 26 for which the user has the editing authority. Then, the user is allowed to select one of the extracted clinical paths 26 to change the date or the person in charge, or to add a new event or the like.

  The clinical path creation / editing unit 54 creates or edits the clinical path 26 based on the operation signal input along with the above-described operation, and newly records or creates the created or edited clinical path 26 in the clinical path DB 18. The clinical path DB 18 is updated by overwriting. In addition, the creation authority that can create the clinical path is provided, it is stored as information user information indicating whether or not this creation authority is given, and the creation of the clinical path is allowed only for the user having the creation authority. May be. In this case, for example, it is conceivable that the creation authority is given only to the user on the medical institution side.

"View clinical path"
In FIG. 6, when “clinical path browsing” is selected from the four processes, the process selection unit 52 operates the clinical path distribution unit 56. As shown in FIG. 8, the clinical path distribution unit 56 refers to the authority information of the clinical path 26 stored in the clinical path DB 18 in accordance with the operation, and extracts the clinical path 26 for which the user has the viewing authority. A distribution path selection screen, which is an operation screen for selecting a clinical path 26 to be distributed from the extracted clinical paths 26, is distributed to the user terminal. When the user performs a selection operation for selecting the clinical path 26 through the distribution path selection screen, an operation signal corresponding to the selection operation is input from the user terminal to the clinical path distribution unit 56. The clinical path distribution unit 56 distributes the clinical path 26 selected by the user to the user's terminal. The distributed clinical path 26 is displayed on the display of the terminal of the distribution destination user (see FIG. 3).

"Clinical path approval"
In FIG. 6, when “clinical path approval” is selected from the four processes, the clinical path approval unit 58 is operated by the process selection unit 52. As shown in FIG. 9, the clinical path approval unit 58 refers to the authority information of the clinical path 26 stored in the clinical path DB 18 with the operation, and extracts the clinical path 26 for which the user has the approval authority. An approval path selection screen, which is an operation screen for selecting a clinical path 26 to be approved from the extracted clinical paths 26, is distributed to the terminal of the authenticated user. When the user performs a selection operation for selecting the clinical path 26 through the approval path selection screen, an operation signal corresponding to the selection operation is input from the user terminal to the clinical path approval unit 58.

  When the clinical path 26 to be approved is selected, the clinical path approval unit 58, for example, information (electronic signature) indicating that approval is performed by a technique of electronically signing using a secret key and a public key, Then, a certificate is generated to prove that the approval is made from the terminal of the user having the approval authority. Then, the clinical path approval unit 58 updates the clinical path DB 18 by storing these electronic signatures and their certificates in association with the approved clinical path 26.

  As described above, the clinical path management device 12 stores information indicating whether the clinical path 26 is approved or not in association with the clinical path 26 (unified management with the clinical path 26). As compared with the case where a consent document indicating approval / disapproval is managed separately, it is possible to prevent a problem that the correspondence between the clinical path 26 and approval / disapproval is broken due to human error such as a mistake. Further, the clinical path management apparatus 12 can simultaneously confirm whether or not there is an approval associated with the clinical path 26 when browsing the clinical path 26 (see FIG. 3). Compared with the case where the presence or absence is confirmed separately, treatment can be started smoothly. Furthermore, since the approval can be performed through the network 14 even when the user is away from the medical institution where the treatment is performed, it is convenient to save the trouble of visiting the medical institution for the approval.

`` Change authority ''
In FIG. 6, when “change authority” is selected from the four processes, the authority selection section 60 is operated by the process selection section 52. As shown in FIG. 10, the authority changing unit 60 displays an authority changing screen 70 (see FIG. 11), which is an operation screen for adding or deleting a user who grants viewing authority or approval authority with operation. To other devices. When the user performs a change operation for changing the authority through the authority change screen, an operation signal corresponding to the change operation is input from the user terminal to the authority change unit 60. The authority changing unit 60 updates the clinical path DB 18 by rewriting the authority information of the clinical path 26 based on the input operation signal.

  As shown in FIG. 11, the authority change screen 70 is provided with check fields 70a and 70b, and the user checks either of the check fields 70a and 70b, so that either of the viewing authority or the authorization authority is checked. Can be selected. When the check column 70a is checked, that is, when the selection to change the viewing authority is made, the authority changing unit 60 refers to the clinical path DB 18, extracts the clinical path 26 for which the user has the viewing area changing authority, and retrieves the search result. It displays on the display part 70c. When the check column 70b is checked, that is, when the selection to change the approval authority is made, the authority changing unit 60 refers to the clinical path DB 18 and extracts the clinical path 26 for which the user has the authority to change the approval range. It displays on the search result display part 70c.

  The search result display section 70c is provided with a check field 70d on the side of the name of each displayed clinical path, and the user checks the check field 70d to change the authority path. 26 can be selected.

  When the clinical path 26 whose authority is to be changed is selected, check fields 70e to 70g, a user designation tag 70h, and a user registration tag 70i are displayed. The check columns 70e to 70g are provided for selecting a range for granting authority from a preset group. By checking the check column 70e, authority for all users registered in the user information DB 20 is provided. By checking the check field 70f, authority can be given to a user registered as a user's relative in the user information DB 20, and by checking the check field 70g, the user information DB 20 is registered as a friend of the user. You can grant authority to a new user.

  Usually, even if the viewing authority is given to the friend, the approval authority is not given. Therefore, when the viewing authority is given (when the check field 70a is checked), the check field 70g. Is displayed and can be checked (browsing authority can be given to a friend), and when the approval authority is granted (when the check field 70b is checked), the check field 70g is not displayed and the check cannot be performed (the approval authority is changed). For example, it may be configured such that only the viewing authority can be granted to the friend (the approval authority cannot be granted).

  Whether the user is a relative of the user is identified based on the user information 28 stored in the user information DB 20. For example, in FIG. 4, when selection is made to grant the relative authorization (or viewing authority) of the clinical path of “Fuji Taro” to a relative (when the check field 70 f is checked), “Fuji” The status of “Taro” is referenced and “Daisuke Fuji” is identified as a relative. Approval authority (or viewing authority) is granted to “Fuji Daisuke”. “Daisuke Fuji” who has been granted the authorization authority (or viewing authority) approves the clinical path of “Taro Fuji” by following the procedure of “Approval of Clinical Path” (or “View Clinical Path”) described above. (Or browse). Similarly, whether or not the user is a friend is also identified based on the user information 28 stored in the user information DB 20, and is granted approval authority (or browsing authority).

  Further, when the user designation tag 70h is operated, the user list of users registered in the user information DB 20 is displayed on a separate screen, and the user to whom authority is given can be individually designated from the user list. Further, by operating the user registration tag 70i, a user who is not registered in the user information DB 20 can be newly registered in the user information DB 20. The registered user is added to the user list displayed in accordance with the operation of the user designation tag 70h, and the user can be given authority by designating this user from the user list.

  As described above, the clinical path management apparatus 12 is convenient because a user to whom browsing authority or approval authority is given can be added or deleted. Further, the clinical path management device 12 grants the authorization authority range change authority to the patient and the attending doctor at the time of generating the clinical path, so that the patient himself or herself is approved such that the patient is unconscious or has dementia. Even if it is not possible, treatment can be started smoothly by giving the approval authority to another user, such as a patient's relative, and obtaining approval.

  In the present invention, information indicating whether or not a clinical path has been approved may be stored in association with the clinical path. Therefore, the detailed configuration is not limited to the above embodiment and can be changed as appropriate. For example, in the above-described embodiment, an example in which authority information is attached to a clinical path has been described. However, authority information may be attached to user information.

  In the above embodiment, the example is described in which the clinical path management device is installed in the operating company that operates the medical support system. However, since the installation location of the clinical path management device can be freely set, for example, the clinical path management device May be installed in a medical institution (such as a hospital).

  Furthermore, in the above embodiment, the example in which the user inputs user information has been described. However, for example, a system different from a medical support system such as the Juki Net or the National Gross Number System (hereinafter, another system) It may be possible to omit the input of user information by using the user information used in. In this case, for example, when the identification information of a user used in another system is input, the clinical path management apparatus accesses the other system, and user information other than the identification information (for example, name, age, address, family relationship, Such as occupations) and automatically registering it as user information. Of course, if you do not register whether it is a relative or not as user information and you give approval authority to the relative of the user (that is, if you need to identify the relative of the user), another system To identify the user's relatives.

  Note that the method of identifying the user's relative is not limited to the method of registering the name of the relative as the user status, for example, registering the terminal ID of the relative and identifying whether or not it is a relative based on the terminal ID May be. Further, relative information of a relative (eg, fingerprint, voiceprint, iris, face image, etc.) may be registered, and the relative of the user may be identified by fingerprint authentication, voiceprint authentication, pupil authentication, face authentication, or the like. Of course, such information for identifying a user's relative is not limited to being stored in the user information DB as user information, but is stored in the user's terminal or a contract company that has a contract with the user's terminal. (For example, it may be stored in a communication company when the user terminal is a telephone (smart phone)) and may be used to identify a user's relative by accessing and referring to a contract company. Also, registration (storage) of information for identifying a user's relatives can be performed at an arbitrary timing.

  Further, in the above-described embodiment, the example in which the user having the browsing authority can browse all the information of the clinical path having the browsing authority has been described, but some information specified in advance among the information included in the clinical path It is also possible to provide a limited viewing authority that can be browsed only by adjusting the type of information that can be browsed by the user. In this way, for example, a relative can view all information, a friend can view only some information, a medical institution user can view all information, and a patient side For example, the user can browse only one piece of information. In this way, when restrictions are placed on information that can be browsed, even if a user has the authority to change the viewing range, information that he / she is restricted to view is restricted to other users. It is preferable to configure so that it cannot be imparted.

  Furthermore, in the above-described embodiment, the example in which the user having the approval range change authority can grant the approval authority to any user has been described. However, the restriction that the approval authority can be given only to some of the users specified in advance. Approval range change authority may be provided, and users who can be granted approval authority may be different depending on the user. In this way, for example, the patient can grant approval authority to any user, and the attending doctor can grant approval authority only for the relatives of the patient.

  Further, in the above embodiment, when the user is in the position of the medical institution, the explanation is given in the example in which the authority given in the initial state is different between the doctor and the other medical staff, but depending on the position and affiliation, the doctor Even if they are different from each other, the granted authority may be different. Similarly, the authority granted to medical staff other than doctors may be different depending on the position or affiliation.

  Furthermore, in the above embodiment, an example has been described in which an authorized user can exercise authority regardless of his / her position, but the user is granted based on the current location of the user. Authority may be restricted. In this case, for example, if the current position of the user's terminal is detected by a GPS system and the user is away from the medical institution by a predetermined distance or more, browsing authority cannot be exercised (even if the user has browsing authority, the clinical path can be viewed It may be possible that the approval authority or the approval range change authority cannot be exercised when the user is away from the patient by a predetermined distance or more. Of course, not only the position information but also the authority to be given to the user may be limited by whether or not the authentication code is correctly input.

  Further, when a clinical path is browsed, a browsing history such as when and which user browsed may be recorded. Furthermore, a function for notifying the timing of the event set by the clinical path may be provided. In this case, it is preferable to notify the timing of the event to a user having a browsing function, a patient and their relatives, a doctor in charge, or the like. Of course, the user who notifies the event may be set by the user himself / herself. Further, when an event is started, user terminals may be connected to each other by voice or a videophone system, and the state of the event may be relayed to a user away from the event location. When relaying events, there is a problem that the user on the patient side does not understand the meaning of the technical terms used by the user on the medical institution side, so the technical terms are detected by voice recognition and the explanation is displayed on the screen It is preferable to explain by voice guidance. Of course, the voice and image data obtained by the relay may be recorded in association with the clinical path.

DESCRIPTION OF SYMBOLS 10 Medical assistance system 12 Clinical path management apparatus 17 Application server 18 Clinical path DB
20 User information DB
26 Clinical Pass 28 User Information 30 AP
32 Storage device 34 Memory 36 CPU
50 User Authentication Unit 52 Processing Selection Unit 54 Clinical Path Creation / Editing Unit 56 Clinical Path Approval Unit 58 Clinical Path Distribution Unit 60 Authority Change Unit 70 Authority Change Screen

Claims (10)

A clinical path database storing a clinical path showing a step-by-step treatment plan until reaching a target state;
A user information database that stores user information about users;
A user authentication unit for authenticating a user based on the user information;
When an instruction to approve the treatment plan is input from a user who has approval authority to approve the treatment plan, information indicating that the treatment plan has been approved is stored in association with the clinical path. Clinical path approval department,
A clinical path management device comprising:   When an instruction to grant and delete the approval authority is input from a user having an approval range change authority that can grant and delete the approval authority, the input instruction is accepted, and the approval authority is granted and deleted. The clinical path management apparatus according to claim 1, further comprising an approval authority changing unit.   When an instruction to browse the clinical path is input from a user who has browsing authority to view the clinical path, a clinical path distribution unit that receives the input instruction and distributes the clinical path is provided. The clinical path management apparatus according to claim 2.   When an instruction to create the clinical path is input from a user who has the creation authority capable of creating the clinical path, the apparatus includes a clinical path creation unit that receives the entered instruction and creates the clinical path. The clinical path management apparatus according to claim 3,   5. The clinical path management apparatus according to claim 4, wherein the authority of the user is stored in association with the clinical path.   6. The clinical path management apparatus according to claim 4, wherein a predetermined authority is given to a predetermined user when the clinical path is created. When creating the clinical path,
The approval authority is granted to a patient to be treated in the clinical path,
The clinical path management apparatus according to claim 6, wherein the approval range change authority is given to the patient and a doctor in charge of the patient.   8. The clinical path management apparatus according to claim 7, wherein the approval range change authority given to the doctor in charge is an authority that can give the approval authority up to the relative of the patient. When creating the clinical path,
The clinical path management apparatus according to any one of claims 6 to 8, wherein the browsing authority is given to a patient who is a treatment target in the clinical path and a doctor in charge of the patient. The viewing authority given to the doctor in charge is the authority to view all information constituting the clinical path,
The clinical path management apparatus according to claim 9, wherein the browsing authority given to the patient is an authority capable of browsing only a part of information constituting the clinical path.

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